20-3117. Dispute resolution; notice of rights
227 words·~1 min read·
/az/title-20/20-3117A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
A. The department in conjunction with the appropriate health care boards shall prescribe the notice outlining an enrollee's rights to dispute surprise out-of-network bills under this article.
B. Health insurers shall include the notice prescribed pursuant to subsection A of this section in each explanation of benefits or other similar claim adjudication notice that is issued to enrollees and that involves covered services provided by a noncontracted health care provider. This subsection applies only to claims that are not subject to an independent dispute resolution pursuant to the No Surprises Act (P.L. 116-120; 134 Stat. 2758; 42 United States Code section 201).
C. If an enrollee contacts a health care provider, a provider's representative or a billing company regarding a dispute involving a surprise out-of-network bill that is not subject to an independent dispute resolution pursuant to the no surprises act (P.L. 116-120; 134 Stat. 2758; 42 United States Code section 201), the health care provider, the provider's representative or the billing company shall provide written notice as prescribed in subsection A of this section to the enrollee of the dispute resolution process.
D. The department shall post on its website information for health care consumers regarding what constitutes a surprise out-of-network bill, how to try to avoid a surprise out-of-network bill and how the dispute resolution process may be used to resolve a surprise out-of-network bill.